Tips to clean your ears — and why ENTs want you to stop removing ear wax with cotton swabs and at-home irrigation kits

Woman using a cotton swab to clean her ear
You've probably used cotton swabs to clean your ears. Here's why ENTs say you shouldn't. (Getty Images)

"Don’t put anything smaller than your elbow in your ear." It's the kind of thing you may have heard your grandmother say, but, for the most part, it’s true, says Dr. Bradley Kesser, an ear, nose and throat (ENT) doctor and professor in otolaryngology at UVA Health in Virginia.

And yes, that means you shouldn't be using cotton swabs to remove wax from your ears. According to experts, this common practice is not only unnecessary but also risky. Here's why.

Most people have probably stuck a cotton swab in their ears at one point another. The experience can feel satisfying — either because of the tingle it gives your ear as you work, or because of the gunk you've been able to clear out. So why do many ENTs advise against it?

Dr. Minka Schofield, a clinical professor of otolaryngology at the Ohio State University Wexner Medical Center, acknowledges that most people have been taught to clean their ears by using a cotton swab. But that doesn't mean it's effective. "The problem with this technique is that we can push the wax deeper into the ear and worsen any impaction,” she tells Yahoo Life.

The skin in the ear canal, Kesser notes, is delicate, and swabs can wear away at it. This can cause what he calls micro-cuts, "which [can be] portals of entry for bacteria, which can cause an ear infection."

Schofield adds that over-cleaning can create a lack of moisture inside the ear canal and can also lead to an outer ear infection. "If you cause trauma to the ear canal it can result in ear bleeding,” she says.

Both Kesser and Schofield have seen swabs pushed so far down patients’ ear canals that they break through the ear drum and cause an ear drum perforation.

Sometimes, the cotton tip of the swab can also come off in the ear, Schofield says. This can make hearing muffled. It can cause an infection, if the cotton has been in there long enough.

“I think people have to be careful because the ear is a very delicate space and manipulating the ear, although it may seem like a minor thing to do, can cause some significant injury to the ear canal and the eardrum," Schofield says. "So avoid sticking things in your ears."

The good news is that you don't need to be worrying too much about keeping your ears clean.

A lot of people associate ear wax with being dirty or unclean, so there’s this kind of aggressive need to keep the ears cleaned out in some way, but we want a certain degree of wax in the ear,” Schofield says.

Wax is beneficial because it “provides a greasy layer to protect the skin from bacteria,” Kesser adds.

What's fascinating about the ear canal, according to Kesser, is that the skin inside it migrates. “So if you put an ink spot on the ear drum, that ink spot would migrate and come all of the way out of the ear canal." As the skin moves it also carries debris and wax out, he adds, doing the work to keep the canal clean.

The ear canal naturally pushes wax to the opening of the ear. "That’s where you should clean — the very outside opening of the ear," Schofield says. But don't reach for a cotton swab; Kesser encourages people to instead use their pinkie and a cold washcloth to clean this part of the outer ear.

While most people don’t need to clean inside their ears, there are some who will need wax removal, but this cleaning should not be attempted at home. Kesser is opposed to ear irrigation kits, and both he and Schofield caution against so-called ear candling — a popular practice in which people light a candle and put the non-lit end in the ear canal. Not only does ear candling not remove ear wax, they say, but it can be extremely dangerous and cause burns.

Instead, people should see their ENT for a professional, in-office cleaning. If your ears are really itchy, you have a sudden loss of hearing or feeling of fullness in your ear or if there is liquid drainage or blood coming out of the ear (a sign of infection), you may need to see your ENT about a possible impaction.

Other people who may need annual or biannual trips for ear cleaning are those who wear hearing aids or, Schofield adds, regularly wear any type of in-ear headphone or bud. “If you have any kind of chronic plugging of the ear or something you’re putting in your ear canal for an extended period of time every day, you are at risk of your wax not being able to move out of the ear canal freely and potentially causing accumulation of wax in the ear canal," she says.